Differentiating treatment episodes from gaps in eyes with diabetic macular oedema

Br J Ophthalmol. 2025 Oct 23;109(11):1279-1282. doi: 10.1136/bjo-2025-327238.

Abstract

The treatment of diabetic macular oedema (DMO) likely involves a series of treatment episodes separated by gaps during which no vascular endothelial growth factor inhibitor injections are delivered. Our aim is to differentiate the episodes and gaps with the isolation forests algorithm using the Fight Retinal Blindness! registry. We analysed 11 786 injection intervals (12 803 injections) and found that the period between adjacent injections≥38 weeks (95% CI 34 to 43 weeks) apart could be regarded as a treatment gap. The results will allow treatment episodes to be isolated so that the treatment patterns of DMO can be characterised more accurately.

Keywords: Macula; Treatment Medical.

MeSH terms

  • Aged
  • Algorithms
  • Angiogenesis Inhibitors* / administration & dosage
  • Angiogenesis Inhibitors* / therapeutic use
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / drug therapy
  • Female
  • Humans
  • Intravitreal Injections
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Male
  • Middle Aged
  • Ranibizumab* / administration & dosage
  • Registries
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Ranibizumab
  • VEGFA protein, human